Laparoscopic trainer

ABSTRACT

A surgical training device ( 10 ) for the practice of surgical techniques. The device ( 10 ) comprises an operation area ( 18 ) arranged to receive an operable structure and a screening wall ( 13 ) having an aperture ( 21 ). The wall ( 13 ) is positioned relative to the operation area ( 18 ) such that the wall prevents direct viewing of the operation area ( 18 ) from at least one position ( 19 ) external the wall ( 18 ). The device further includes an optical system comprising a first mirror ( 24 ) and a second mirror ( 25 ). The first mirror ( 24 ) is arranged to reflect a primary image of the operation area ( 18 ) to the second mirror ( 25 ) which in turn is arranged to reflect a secondary image of the operation area ( 18 ) that is visible from the external position ( 19 ). The position and orientation of the mirrors and the aperture ( 21 ) is such that only the secondary image of the operation area ( 18 ) is visible from the external position ( 19 ).

FIELD OF THE INVENTION

[0001] The present invention relates to a device that assists surgeonsto learn and practise endoscopic surgical procedures.

BACKGROUND OF THE INVENTION

[0002] Minimally invasive surgical procedures are now often favouredover “open” or conventional surgery due to a lower post-operativemorbidity, shorter post-operative stay, less pain, decreased cost andquicker recovery period.

[0003] While often favoured for the above reasons, conventional opensurgery does have the advantage that the surgeon is presented with athree-dimensional environment to which their eyes are accustomed ineveryday living. Further, when the surgeon manipulates the operativeinstruments, there is a direct visual response to the actions performedby their hands.

[0004] In endoscopic procedures, such as a laparoscopic procedure, theoperative field is instead perceived as a magnified two-dimensionalimage seen by way of a video camera and television screen. The result isa disassociation between the surgeon's hand movements and the end resultof those movements as visualised on the television screen. This occursbecause the surgeon's eyes cannot focus on the spatial orientation oftheir hands in relation to the actual operative task.

[0005] A further significant difference is that the operative field, asviewed in an endoscopic procedure, lacks any depth perception. This addsto the surgeon's difficulty in appropriately positioning theinstruments. It, in effect, necessitates the surgeon to retrain his orher eyes to estimate the actual distance between the structures beingmanipulated.

[0006] Surgeons typically require a significant period of training todevelop the new set of fine coordinated movements required to performcomplicated endoscopic procedures, such as suturing and knot tying. Thistraining typically involves use of relatively expensive and non-portablevideo and television equipment that provides an image of an operationarea being practised upon by the surgeon.

[0007] The present invention provides an alternative training device forsurgeons to learn and practise endoscopic surgical techniques.

[0008] Any discussion of documents, acts, materials, devices, articlesor the like which has been included in the present specification issolely for the purpose of providing a context for the present invention.It is not to be taken as an admission that any or all of these mattersform part of the prior art base or were common general knowledge in thefield relevant to the present invention before the priority date of eachclaim of this application.

SUMMARY OF THE INVENTION

[0009] Throughout this specification the word “comprise”, or variationssuch as “comprises” or “comprising”, will be understood to imply theinclusion of a stated element, integer or step, or group of elements,integers or steps, but not the exclusion of any other element, integeror step, or group of elements, integers or steps.

[0010] The present invention is a surgical training device for use bysurgeons, including trainee surgeons. The device is particularlydesigned to allow surgeons to practise endoscopic procedures where a twodimensional image of the operation area is depicted on a television ormonitor screen.

[0011] According to one aspect, the present invention is a surgicaltraining device for the practice of surgical techniques on an operablestructure, the device comprising:

[0012] an operation area arranged to receive an operable structure;

[0013] a screening wall having a viewing means, the wall beingpositioned relative to the operation area such that the wall preventsdirect viewing of the operation area from at least one position externalthe wall;

[0014] an optical system comprising a first mirror and at least a secondmirror, the first mirror being arranged to reflect a primary image ofthe operation area to the second mirror which in turn is arranged toreflect a secondary image of the operation area that is visible fromsaid external position via the viewing means.

[0015] A surgeon using the device is forced to view the operation areaby viewing the reflected two dimensional image of the operation area.The device thereby can be used by a surgeon to practise surgicaltechniques despite not being able to directly view the operation area.

[0016] As used herein, the term operable structure can be taken to beany structure that is suitable for the practice of surgical techniques.For example, the operable structure can comprise an anatomicalstructure, such as a sample of animal body tissue. In another case, theanatomical structure can be a sample of human tissue thus providing thesurgeon with a sample of tissue identical or similar to that that willbe encountered in surgery. In another case, the operable structure canbe fabricated from a synthetic material designed to replicate thefeatures of an anatomical structure.

[0017] In one embodiment, the optical system is adapted to preventviewing of a primary reflection of the operation area from said externalposition. In another embodiment, the optical system is adapted to allowviewing of a secondary reflection of the operating area from saidexternal position. In yet another embodiment, the optical systemprevents viewing of tertiary and/or higher numbered reflections fromsaid external position. In a still further embodiment, the opticalsystem only allows viewing of the secondary reflection of the operatingarea from said external position.

[0018] In a preferred embodiment, the device includes a chambersurrounding the operation area. The chamber can comprise a box having abase and at least the screening wall. The base can be rectangular withthe box having the screening wall, a rear wall and two side wallsextending from the front screening wall to the rear wall. At least aportion of the front and rear walls, respectively, can be parallel andthe respective side walls can also be parallel. The front wall, rearwall and side wall preferably each extend upwardly from the base to arespective upper end. The respective upper ends of the side walls can beco-planar.

[0019] The front screening wall of the chamber is preferably opaque. Thefront wall is preferably opaque as it is envisaged that a surgeon usingthe device would use the device when positioned in front of the frontwall. The other walls can also be opaque. It is, however, possible thata portion or all of the side walls and the rear wall may be transparentto allow viewing of the operation area from external positions otherthan said external position. For example, the side walls and/or rearwall may be transparent to allow a trainer or teacher to readily viewthe operation area during use of the device by a trainee surgeon.

[0020] The screening wall preferably comprises a first portion extendingupwardly to an upper end from the first side of the base, and a secondportion extending upwardly and inwardly from the upper end of the firstportion of the screening wall. The second portion also preferably hasthe same width as the first portion and has an outer face and an innerface. The second portion of the screening wall is preferably adjustablymountable to the first portion. Once mounted, the angle between thesecond portion and the first portion is preferably variable.

[0021] The screening wall preferably includes a viewing means positionedin the second portion thereof that allows visualisation of saidreflected image of the operation area provided by the optical system. Ina preferred embodiment, the viewing means only allows visualisation of asecondary reflection of the operating area. The viewing means cancomprise an aperture in the screening wall. In another embodiment, theviewing means can comprise a polymeric or glass window. The position ofthe viewing means relative to the first portion of the screening wall isvariable by relative movement of the second portion of the screeningwall.

[0022] Respective support walls preferably extend upwardly from therespective side walls to the second portion. The support walls are alsopreferably opaque. The support walls can be integrally formed with thesecond portion of the screening wall or removable therefrom.

[0023] The screening wall also preferably includes at least oneinstrument portal. The screening wall preferably has two instrumentportals but a greater number can be envisaged. The other walls of thechamber, such as the front wall, can also each include at least oneinstrument portal. The portals are preferably adapted to allow insertionof surgical endoscopic instruments into the chamber. The portals arepreferably adapted to represent the dimensions of typical openingsformed in a patient's body during endoscopic surgery. The one or moreportals in the screening wall are preferably positioned adjacent orbelow the viewing means. More preferably, the one or more portals arepositioned adjacent or below a lower edge of the viewing means.

[0024] The operation area can comprise a tray, dish or other suitablecontainer. The tray is preferably adapted to surround the contents ofany tissue operated upon within the tray and substantially preventspillage of tissue and fluids. In use, the tray is positioned such thatits reflected image is visible from said external position through useof the optical system.

[0025] The optical system preferably comprises a first mirror and atleast a second mirror. The first mirror is preferably positioned on theinner face of the screening wall. Movement of the screening wall resultsin movement of the first mirror mounted thereto. In a preferredembodiment, the first mirror will be positioned on the inner face belowthe viewing means. The first mirror is preferably positioned andoriented to reflect an inverted image of the operation area towards therear wall of the chamber. The first mirror can be a magnifying mirror.

[0026] The second mirror is preferably positioned at or adjacent therear wall of the chamber. The second mirror can further be mounted onthe base of the device. The second mirror is preferably positioned andoriented to reflect the inverted image provided by the first mirrortowards the viewing means in the screening wall. The second mirrorreorientates the inverted image of the operation area provided by thefirst mirror. The second mirror is also preferably a magnifying mirror.The second mirror preferably magnifies the image by a factor of two (2).Other magnification factors can be envisaged. The second mirror ispreferably adjustably mountable within the device to allow visualisationof only a secondary reflection of the operating area at said positionthrough the viewing means.

[0027] In another embodiment of the invention, the device can include alight source. The light source can have an internal power supply such asa battery or can be externally powered. The light source preferably isadapted to provide a level of illumination similar to that available toa surgeon when performing actual endoscopic procedures on a patient.

[0028] The device according to the present invention is preferablycompact and portable. The device can preferably be dismantled andreadily transported in a case. This allows the user to readily set upand use the device in any convenient location.

[0029] According to a further aspect, the present invention is a methodof practising one or more surgical techniques comprising the steps of:

[0030] assembling the device as defined herein and positioning ananatomical structure in the operation area thereof;

[0031] adjusting the primary mirror and/or the second mirror such that asecondary image of the anatomical structure reflected from the secondmirror is visible through the viewing means; and

[0032] practising at least one surgical technique on the anatomicalstructure while viewing the secondary image of the anatomical structurethrough the viewing means.

BRIEF DESCRIPTION OF THE DRAWINGS

[0033] By way of example only, a preferred embodiment of the inventionis now described with reference to the accompanying drawing, in which:

[0034]FIG. 1 is a perspective view of the training device according tothe present invention.

PREFERRED MODE OF CARRYING OUT THE INVENTION

[0035] A portable device for surgeons to learn and practise endoscopicsurgical procedures is depicted generally as 10 in FIG. 1.

[0036] The device 10 comprises a chamber 11 having a base 12, a firstportion 13 of a front screening wall, a rear wall 14 and side walls 15.In the depicted embodiment, the base and walls are formed from an opaquematerial. It will be appreciated that in other embodiments, at least therear wall 14 and at least a portion of the respective side walls 15could be formed from a transparent material to allow ready viewing ofthe interior of the chamber from the side or rear of the chamber 11. Thefront wall 13, rear wall 14 and side walls 15 are removably mounted tothe base 12 to allow ready dismantling of the chamber 11 for transport.

[0037] Extending upwardly and inwardly from the upper edge of the frontwall 13 is a second portion 16 of the screening wall. The second portion16 of the wall is adjustably supported by the upper edge of the firstportion 13 of the front wall and two support walls 17. The adjustablemounting allows the angle of the second portion 16 relative to the upperedge of the first portion 13 to be adjusted as required. The secondportion 16 and the respective support walls 17 are opaque in thedepicted embodiment. The position and orientation of the second portion16 of the screening wall is such so as to prevent direct visualisationof the operation area, depicted as a tray 18 in the drawing, from thenormal external position of the eyes of the trainee using the device 10,represented by eye 19.

[0038] In the depicted embodiment, the second portion 16 of thescreening wall has a viewing portal 21, comprising an aperture in thewall, that allows direct visualisation of the second mirror 25. Thesecond portion 16 of the screening wall also has two instrument portals22 extending through the wall immediately above the upper edge of thefirst portion 13 of the wall and below the viewing portal 21. Otherpositions and different numbers of instrument portals can be envisaged.As depicted, the portals 22 allow the surgeon to insert endoscopicinstruments 23, such as trocars, cannulas, clamps, and scissors, intothe chamber 11 so that they can manipulate tissue, or another operablestructure, positioned in the tray 18.

[0039] Positioned on the inner face of the second portion 16 of thescreening wall is a first mirror 24 (depicted in phantom). The firstmirror 24 is oriented to reflect light that has travelled forwardly fromthe tray 18 rearwardly back towards the rear wall 14 of the chamber 11.As such, the first mirror 24 reflects an inverted primary reflectedimage of the tray 18 and its contents towards the second mirror 25.

[0040] The second mirror 25 is positioned and oriented to reflect theinverted image back through the viewing portal 21 in its correctorientation (ie. a secondary image) such that it can be viewed by thesurgeon when they are at position 19. In the depicted embodiment, thesecond mirror 25 also magnifies the image by a factor of two (2). Theangle made between the second mirror 25 and the base 12 is adjustable toallow a user to ensure that only a secondary image of the contents ofthe tray 18 is viewable when the user has their eye at position 19. Theorientation of the mirrors and the position of the aperture 21 in thescreening wall ensures that direct visualisation of the tray 18, andviewing of a primary image or tertiary or greater image from the secondmirror 25 is not visible when the surgeon's eye is at position 19.

[0041] The present device 10 serves to provide a surgeon with atwo-dimensional secondary image of an operation area 18 through use of afirst mirror 24 and second mirror 25. By only being able to view a twodimensional image at a position separated from the operation areadefined by tray 18, the surgeon is required to operate in an equivalentmanner to that necessary in actual endoscopic surgery.

[0042] When not in use or while being transported, the device 10 can bestored in a carry case. When required, the components of the device 10can be removed from the case and assembled. Once the chamber 11 isassembled and the first mirror 24 and second mirror 25 are appropriatelyaligned to allow visualisation of a secondary reflection of tray 18through portal 21, the device 10 is ready for use. An appropriate sampleof body tissue, human or animal, or a synthetic operable structure, canbe placed in the tray 18 and then used for endoscopic surgical practiseas described above.

[0043] When the practise session is complete, the tissue can be removedfrom the tray 18 and the chamber 11 cleaned. If desired, the device 10can then be dismantled and packed away until next required.

[0044] It will be appreciated by persons skilled in the art thatnumerous variations and/or modifications may be made to the invention asshown in the specific embodiments without departing from the spirit orscope of the invention as broadly described. The present embodimentsare, therefore, to be considered in all respects as illustrative and notrestrictive.

1. A surgical training device for the practice of surgical techniques onan operable structure, the device comprising: an operation area arrangedto receive an operable structure; a screening wall having a viewingmeans, the wall being positioned relative to the operation area suchthat the wall prevents direct viewing of the operation area from atleast one position external the wall; an optical system comprising afirst mirror and at least a second mirror, the first mirror beingarranged to reflect a primary image of the operation area to the secondmirror which in turn is arranged to reflect a secondary image of theoperation area that is visible from said external position via theviewing means, the orientation of the second mirror being adjustablerelative to the operation area and the first mirror such that anyprimary image or tertiary or greater image reflected from the secondmirror is not visible via the viewing means of the screening wall.
 2. Asurgical training device of claim 1 wherein the device further comprisesa chamber surrounding the operation area, the chamber comprising a baseand at least the screening wall extending upwardly from a first side ofsaid base.
 3. A surgical training device of claim 2 wherein the chamberfurther comprises a rear wall extending upwardly from a second side ofthe base distal the first side, and two opposed side walls extendingfrom the screening wall to the rear wall.
 4. A surgical training deviceof claim 3 wherein the screening wall of the chamber is opaque.
 5. Asurgical training device of claim 4 wherein the screening wall comprisesa first portion extending upwardly to an upper end from the first sideof the base, and a second portion extending upwardly and inwardly fromthe upper end of the first portion of the screening wall.
 6. A surgicaltraining device of claim 5 wherein the second portion of the screeningwall has an outer face and an inner face and is adjustably mountable tothe first portion.
 7. A surgical training device of claim 6 wherein theviewing means is in the second portion of the screening wall.
 8. Asurgical training device of claim 7 wherein the viewing means comprisesan aperture in the second portion of the screening wall.
 9. A surgicaltraining device of claim 8 wherein the viewing means comprises a windowin the second portion of the screening wall.
 10. A surgical trainingdevice of claim 6 wherein the screening wall has at least one instrumentportal formed therein.
 11. A surgical training device of claim 10wherein the at least one instrument portal is in the second portion ofthe screening wall.
 12. A surgical training device of claim 11 whereinthe one or more portals in the screening wall are positioned adjacent orbelow the viewing means.
 13. A surgical training device of claim 6wherein the first mirror is positioned on the inner face of the secondportion of the screening wall.
 14. A surgical training device of claim13 wherein the first mirror is positioned on the inner face of thesecond portion of the screening wall below the viewing means.
 15. Asurgical training device of claim 1 wherein the first mirror is amagnifying mirror.
 16. A surgical training device of claim 1 wherein thesecond mirror is a magnifying mirror.
 17. A surgical training device ofclaim 16 wherein the second mirror magnifies the image by a factor oftwo (2).
 18. A method of practising one or more surgical techniques onan operable structure comprising the steps of: assembling the device ofclaim 1 and positioning an operable structure in the operation areathereof; adjusting the primary mirror and/or the second mirror such thata secondary image of the operable structure reflected from the secondmirror is visible through the viewing means; and practising at least onesurgical technique on the operable structure while viewing the secondaryimage of the operable structure through the viewing means.